Case report: successful use of short-term add-on tocilizumab for multirefractory systemic flare of adult-onset Still's disease.
, Ito R
, Watanabe M
, Hayami Y
, Maeda S
, Sasaki K
, Iwagaitsu S
Division of Rheumatology, Nagoya City University Hospital and the Department of Medical Oncology and Immunology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, 467-8601, Japan, email@example.com.
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We report on a 64-year-old woman with multirefractory flare of adult-onset Still's disease successfully treated with six-month course of add-on anti-interleukin 6 receptor antibody, tocilizumab. Before administration of tocilizumab, the combination therapy with 80 mg/day of prednisolone and cyclosporine or tacrolimus for five weeks, two courses of pulse methylprednisolone, and high-dose intravenous immunoglobulin could not control the disease. Add-on tocilizumab dramatically improved her disease state and enabled tapering of corticosteroid and tacrolimus. Furthermore remission has been maintained on low-dose corticosteroid and tacrolimus after withdrawal of tocilizumab. This case report suggests that short-term add-on tocilizumab might be a useful therapeutic option for patients with multirefractory flare of polycyclic systemic adult-onset Still's disease.
PMID: 20842515 [PubMed - as supplied by publisher]